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https://www.readbyqxmd.com/read/29168911/pre-operative-parameters-do-not-reliably-identify-post-operative-respiratory-risk-in-children-undergoing-adenotonsillectomy
#1
Surendran Thavagnanam, Saou Y Cheong, Karuthan Chinna, Anna M Nathan, Jessie A de Bruyne
AIM: Adenotonsillectomy is performed in children with recurrent tonsillitis or obstructive sleep apnoea. Children at risk of post-operative respiratory complications are recommended to be monitored in paediatric intensive care unit (PICU). The aim of the study is to review the risk factors for post-operative complications and admissions to PICU. METHODS: A review of medical records of children who underwent adenotonsillectomy between January 2011 and December 2014 was performed...
November 23, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29168319/hospital-based-routine-hiv-testing-in-high-income-countries-a-systematic-literature-review
#2
A Elgalib, S Fidler, K Sabapathy
OBJECTIVES: To produce a summary of the published evidence of the barriers and facilitators for hospital-based routine HIV testing in high-income countries. METHODS: Electronic databases were searched for studies, which described the offer of HIV testing to adults attending emergency departments (EDs) and acute medical units (AMUs) in the UK and US, published between 2006 and 2015. Other high-income countries were not included, as their guidelines do not recommend routine testing for HIV...
November 23, 2017: HIV Medicine
https://www.readbyqxmd.com/read/29167832/assessment-of-nutritional-status-in-laparoscopic-gastrectomy-for-gastric-cancer
#3
REVIEW
Young-Gil Son, In Gyu Kwon, Seung Wan Ryu
Malnutrition is very common in gastric cancer patients and can be detected in up to 85% of patients with gastric cancer. Malnutrition is associated with increased morbidity and mortality, prolonged hospital stay, poor treatment tolerance, and lower survival rate. Malnutrition also has an impact on quality of life. The early detection of nutritional risk with appropriate nutritional care can significantly reduce patient's postoperative morbidity and mortality. Because there is no gold standard tool, appropriate tools should be selected and applied depending on one's institutional conditions...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29166819/pregnancy-outcomes-among-women-with-asthma
#4
Haitham Baghlaf, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
PURPOSE: The purpose of this study is to examine the association between maternal asthma and pregnancy, delivery and neonatal outcomes. MATERIALS AND METHODS: We carried out a retrospective cohort study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) database from 2003 to 2011. Among women who delivered during this time period, we compared pregnancy, delivery, and neonatal outcomes in asthmatics versus non-asthmatics. Multivariate logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29166783/improving-asthma-related-outcomes-among-children-participating-in-the-head-off-environmental-asthma-in-louisiana-heal-phase-ii-study
#5
Kristi Isaac Rapp, Leonard Jack, Candice Wilson, Sandra Carr Hayes, Robert Post, Ellen McKnight, Floyd Malveaux
PURPOSE: Pediatric asthma disproportionately affects low-income and minority children. The HEAL (Head-Off Environmental Asthma in Louisiana), Phase II Project was a collaborative effort with a primary focus to improve pediatric asthma management in New Orleans, Louisiana. The purpose of this article is to report clinical outcomes captured at baseline and 12-month follow-up. METHOD: HEAL (Head-off Environmental Asthma in Louisiana), Phase II was a pre-post intervention study that enrolled children ages 2 to 18 years of age with a diagnosis of asthma to receive asthma education within the clinic setting...
November 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/29164743/patient-initiated-recruitment-for-clinical-research-evaluation-of-an-outpatient-letter-research-statement
#6
Matthias Wienroth, Louise Caffrey, Charles Wolfe, Christopher McKevitt
BACKGROUND: UK Hospital Trusts are charged with increasing patients' research awareness and willingness to take part in research. This includes implementing strategies to encourage patient-initiated enquiries about participation. OBJECTIVES: To evaluate the impact of a research statement inserted in outpatient letters in one clinical service, and to derive suggestions on potential steps towards increasing patient-initiated recruitment. SETTING: A medical outpatient clinic of a research-active hospital trust, serving an inner-city multi-ethnic population across two boroughs...
November 22, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29164170/impact-of-procalcitonin-guided-antibiotic-management-on-antibiotic-exposure-and-outcomes-real-world-evidence
#7
Michael R Broyles
Background: Delayed pathogen identification and nonspecific clinical findings make definitive decisions regarding antibiotics challenging. The stimuli of bacterial toxins and inflammation make procalcitonin (PCT) unique in its ability to differentiate bacterial infection from other causes of inflammation, and thus it is useful for antibiotic management. The objective of our study was to evaluate the impact of a PCT algorithm (PCT-A) on current practice. Methods: A single-center, retrospective cohort study was conducted to evaluate the impact of adding PCT-A to stewardship practices...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29163728/results-of-a-quality-improvement-project-aimed-at-eliminating-healthcare-waste-by-changing-medical-resident-test-ordering-behavior
#8
Sushilkumar Satish Gupta, Radhika Voleti, Vimbai Nyemba, Selma Demir, Olaoluwatomi Lamikanra, Nomsa Musemwa, Angela Saverimuthu, Kamaldeen Agoro, Robert D Kalter, Peter Homel, Melvyn Hecht, Lawrence B Wolf, Edward K Chapnick, Michael G Kantrowitz, Stephan L Kamholz
Background: In light of rising healthcare costs and evidence of inefficient use of medical resources, there is growing interest in reducing healthcare waste by clinicians. Unwarranted lab tests may lead to further tests, prolonged hospital stays, unnecessary referrals and procedures, patient discomfort, and iatrogenic anemia, resulting in significant economic and clinical effects. Blood tests are essential in guiding medical decisions, but they are also associated with significant financial and clinical costs...
December 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29162953/evaluation-of-spot-urinary-albumin-creatinine-ratio-as-screening-tool-in-prediction-of-pre-eclampsia-in-early-pregnancy
#9
Vineet V Mishra, Preeti A Goyal, Roy Priyankur, S Choudhary, Rohina S Aggarwal, Khushali Gandhi, Bhumika Vyas, Shaheen Hokabaj
Objective: The aim of this study was to establish whether a spot urinary albumin/creatinine ratio (ACR) measured between 20 and 28 weeks of gestation can predict subsequent pre-eclampsia in asymptomatic pregnant women. Design: Prospective observational study. Subjects: The patients included sixty-two women with singleton pregnancy, normal renal function and no evident proteinuria, attending antenatal clinics between 20 and 28 weeks of gestation in a tertiary care hospital...
December 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29162608/robotic-arm-assisted-versus-conventional-unicompartmental-knee-arthroplasty-exploratory-secondary-analysis-of-a-randomised-controlled-trial
#10
M J G Blyth, I Anthony, P Rowe, M S Banger, A MacLean, B Jones
OBJECTIVES: This study reports on a secondary exploratory analysis of the early clinical outcomes of a randomised clinical trial comparing robotic arm-assisted unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis of the knee with manual UKA performed using traditional surgical jigs. This follows reporting of the primary outcomes of implant accuracy and gait analysis that showed significant advantages in the robotic arm-assisted group. METHODS: A total of 139 patients were recruited from a single centre...
November 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/29162440/automated-external-defibrillators-in-the-hospital-a-case-of-medical-reversal
#11
John A Stewart
Automated external defibrillators (AEDs) emerged in the 1980s as an important innovation in pre-hospital emergency cardiac care (ECC). In the years since, the American Heart Association (AHA) and the International Liaison Committee for Resuscitation (ILCOR) have promoted AED technology for use in hospitals as well, resulting in the widespread purchase and use of AED-capable defibrillators. In-hospital use of AEDs now appears to have decreased survival from cardiac arrests. This article will look at the use of AEDs in hospitals as a case of "medical reversal...
November 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29162073/patient-navigation-to-improve-diabetes-outpatient-care-at-a-safety-net-hospital-a-retrospective-cohort-study
#12
Michal Horný, Wiljeana Glover, Gouri Gupte, Aruna Saraswat, Varsha Vimalananda, James Rosenzweig
BACKGROUND: Recent emphasis on value based care and population management, such as Accountable Care Organizations in the United States, promote patient navigation to improve the quality of care and reduce costs. Evidence supporting the efficacy of patient navigation for chronic disease care is limited. The objective of this study was to evaluate the effect of a patient navigation program on medical and administrative outcomes among patients with diabetes in an urban, safety-net hospital clinic setting...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29162022/confronting-the-challenge-of-beta-lactam-allergies-a-quasi-experimental-study-assessing-impact-of-pharmacy-led-interventions
#13
Steven C Krey, Jeff Waise, Lee P Skrupky
OBJECTIVE: To improve allergy history documentation and increase the use of beta-lactams when appropriate in patients with a reported beta-lactam allergy. METHODS: This pre-post study was conducted at a 167-bed tertiary care community hospital and evaluated multidisciplinary interventions on allergy documentation and antibiotic selection. Interventions included education, creation of local practice guidelines, and modified practices for pharmacists and pharmacy technicians...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29161399/global-lessons-developing-military-trauma-care-and-lessons-for-civilian-practice
#14
T Woolley, J A Round, M Ingram
The wars in Iraq and Afghanistan have helped to shape the modern Defence Medical Services. Many lessons were learnt including the need for rapid haemorrhage control, senior decision-making and the evolution of deployed transfusion support. These changes were implemented simultaneously with a coherent, end-to-end medical plan from point of wounding through to rehabilitation. Implementation of the medical plan is harmonious with the NHS trauma pathway, and is key to ensuring effective delivery. Military anaesthetists have a long pre-deployment training pathway starting with a Certificate of Completion of Training (CCT) in anaesthesia and/or critical care, and with an emphasis on military skills related to their specific role...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160925/effects-of-swaddled-and-traditional-tub-bathing-methods-on-crying-and-physiological-responses-of-newborns
#15
Sinem Yalnızoğlu Çaka, Duygu Gözen
PURPOSE: The purpose of this study was to examine the effects of two bathing methods on crying duration and physiological measurements of newborns. DESIGN AND METHODS: A randomized trial design was used in this study. The sample consisted of newborns (n = 80) who were admitted to neonatal intensive care unit of a university hospital located in a large city. The groups were determined as swaddled bathing (SB) (n = 40) and traditional tub bathing (TTB) (n = 40) by using random number table...
November 21, 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/29160426/impact-assessment-of-an-automated-drug-dispensing-system-in-a-tertiary-hospital
#16
Débora de-Carvalho, José Luiz Alvim-Borges, Cristiana Maria Toscano
OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013) and post- (October 2013-October 2014) intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy...
October 2017: Clinics
https://www.readbyqxmd.com/read/29160408/cognitive-performance-of-stunted-pre-school-children-undergoing-nutritional-recovery-treatment
#17
Thaíse Morais Silva, Nassib Bezerra Bueno, Maria de Lourdes da Silva Gomes de Azevedo, Ana Paula Grotti Clemente, Telma Maria de Menezes Toledo Florêncio
OBJECTIVE: To determine if the treatment of stunted children offered at a specialized center influences their cognitive performance. METHODS: Two groups of children from vulnerable families were selected, one consisting of stunted children being treated at the Nutrition Education and Recovery Center (CREN), and the other group of eutrophic children from a local, public day care center. At CREN, children are treated in a day-hospital system (9 hours/day, 5 days/week), receiving medical, nutritional and psycho-pedagogical support...
November 13, 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/29160128/hospital-utilization-for-patients-with-amyotrophic-lateral-sclerosis-in-saskatoon-canada
#18
Adrianna Gunton, Gregory Hansen, Kerri Lynn Schellenberg
OBJECTIVE: This retrospective study reviewed hospital and intensive care unit (ICU) admissions for patients with amyotrophic lateral sclerosis (ALS) in Saskatoon, Canada, between 2005 and 2017. The purpose was to understand hospital utilization and admission patterns for patients with ALS in the absence of coordinated multidisciplinary care. METHODS: Hospital/ICU admissions were detected at two hospitals in Saskatoon using the International Classification of Diseases (ICD-10) coding for ALS...
November 21, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29160002/a-randomized-double-blind-trial-of-needle-free-injected-lidocaine-versus-topical-anesthesia-for-infant-lumbar-puncture
#19
Ryan Caltagirone, Vidya R Raghavan, Kathleen Adelgais, Genie E Roosevelt
OBJECTIVES: Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection which may be painful or topical application which is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative to these modalities. We compared a needle-free jet-injection system (J-Tip(™) ) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#20
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
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